Abstract 16510: Acute Use Impairs Vascular Function in Exclusive Juul Users (the Jive Study)

Abstract

Introduction: The use of pod-based electronic cigarettes such as JUUL has especially increased among youth and young adults. Due to its popularity and high nicotine delivery as salts, JUUL warrants assessment of its cardiovascular effects. Hypothesis: JUUL use alters vascular function. Methods: In the JUUL Impact on Vascular Effects (JIVE) Study, we evaluated endothelial function and blood pressure (BP) in healthy young adults aged 18-40 who were either tobacco nonusers (N=23), exclusive combustible cigarette users (N=17) or exclusive JUUL users (N=15). Results: As shown in the figure, no differences were noted in baseline brachial artery FMD across the 3 groups. Both JUUL and combustible cigarette users had higher systolic and diastolic BP compared to nonusers (P<0.01). Following 10-minute structured use, JUUL decreased FMD more than nonuse (P<0.01) and was similar to combustible cigarette use (P=0.30 vs JUUL). These differences persisted in models adjusted for age, race and sex. Additionally, JUUL use induced an acute rise in systolic BP (6 ± 6mmHg) that differed from nonuse (0.3 ± 5 mmHg, P=0.001) but was similar to combustible cigarette use (8 mmHg, P=1.0). Urinary cotinine and nicotine levels were higher in combustible cigarette and JUUL users following acute exposure (general linear model adjusted for urinary creatinine with overall P<0.01, combustible cigarette vs nonusers P<0.01, JUUL vs nonusers P<0.01). Conclusions: Our results indicate that acute and chronic JUUL use are associated with higher BP, and acute use with a decrease in endothelial function similar to acute combustible cigarette use, thereby suggesting that JUUL alters vascular function both chronically and upon acute exposure in healthy young adults. Further studies are needed to evaluate the long-term impact of JUUL use on vascular health.